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Prevalence of Laryngoresponders in the General Population

Hoch, Sarah Prevalence of Laryngoresponders in the General Population. Master's Thesis, University of Pittsburgh. (Unpublished)

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Introduction: Over four decades ago Aronson proposed that some individuals are laryngoresponders, i.e., their voice and/or larynx is uniquely vulnerable to stress, and that this status might predispose them to certain voice disorders. It remains unknown what proportion of the population would report that their larynx and/or voice is vulnerable to stress. The current study aimed to determine the prevalence of self-identified laryngoresponders in the
general population. Based on preliminary data from the Helou Laboratory for Vocal Systems Anatomy and Physiology Research, we hypothesized a prevalence of 20%. We also hypothesized that more females would identify as laryngoresponders than males, based on the higher prevalence of functional voice disorders in women than in men. Finally, we hypothesized that laryngoresponders would report higher stress levels than non-laryngoresponders based on past evidence that individuals with muscle tension dysphonia self-report higher stress levels and stress-reactive personality traits.
Methods: We recruited 1,217 participants between age 18 and 65 to complete an online survey of where in the body they tend to physically manifest stress. To avoid biasing participants toward our region of interest (i.e., the larynx) or its functions (e.g., voice, swallowing), the entire body was surveyed. On a line-drawn figurine, participants selected all general bodily regions in which they experienced physical stress symptoms (e.g., abdomen, head) in the past month. Then, for each region, they reported the severity of symptoms in this region and were invited to describe their symptoms in a free-text format. Next, participants completed the Perceived Stress Scale (PSS), a validated measure of perceived stress over the past one month. Lastly, we directly asked participants if they experience voice, swallowing, and/or laryngeal symptoms in response to stress. Data for all participants who selected the front-of-neck/throat region was used post-hoc to manually code laryngoresponders. Symptomology was thematically coded to determine the prevalence of laryngeal symptoms among self-identified laryngoresponders.
Results: A total of 1,217 adults (77.5% assigned female at birth, mean age 36.1 years [SD = 13.7]) completed the demographics questionnaire. Of these, 1,145 participants responded to the figurine and 995 finished the survey in its entirety. We identified four categories of laryngoresponders based on survey response patterns. The prevalence of self-identified laryngoresponders in the general population was determined to be 16.86% unprompted, and 45.42% when participants were asked directly about the larynx. Of the unprompted laryngoresponders, 54.92% rated their symptom severity at a 5 (moderate) or higher (more severe). These unprompted laryngoresponders reporting moderate to severe symptoms made up 9.25% of the participants who responded to the figurine. Reported symptoms varied widely. Unprompted responses largely included reports of tightness/tension in the throat region, while prompted responses also included voice and swallowing symptoms. Contrary to our hypothesis, being assigned female at birth was not significantly correlated with laryngoresponsiveness. Compared to non-laryngoresponders, laryngoresponders reported statistically significantly higher (worse) scores on the PSS.
Conclusions: This study estimated the point-prevalence of self-identified laryngoresponders (16.86% unprompted) and characterized their symptom profiles for the first time. The study indicates that laryngoresponders report higher levels of stress than non-laryngoresponders. It also supports the popularly-cited relationship between voice and stress. Implications of these findings and suggestions for future work are discussed.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Hoch, Sarahsdh61@pitt.edusdh61
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairHelou, Leah
Committee MemberGartner-Schmidt,
Committee MemberCoyle,
Defense Date: 8 March 2022
Submission Date: 18 April 2022
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 76
Institution: University of Pittsburgh
Schools and Programs: School of Health and Rehabilitation Sciences > Communication Science and Disorders
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: stress, larynx, voice, laryngoresponder, laryngoresponders, Perceived Stress Scale, stress response, physical stress response, physical manifestations of stress
Date Deposited: 07 Sep 2022 15:53
Last Modified: 07 Sep 2022 15:53


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